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Hospitals, uninsured patients applaud Medicaid expansion

Published: Thursday, February 21, 2013 at 8:12 p.m.

Last Modified: Thursday, February 21, 2013 at 9:04 p.m.

HOLLY HILL — Fifty-eight-year-old Brenda Hart is one of hundreds of thousands of Floridians who slip through the cracks of the health care system.

The Holly Hill resident worked most of her life but lost her insurance when she came down with colon cancer. She tried to apply for Medicaid only to receive a letter stating she earns too much income to qualify.

Hart and her husband have a combined household income of $15,000, said their daughter Heather Sanders, 36.

"I never realized until my mom got sick how bad the system really is," Sanders said. "Everybody talks about this hole. I never thought they would be in this hole at $15,000."

Now, Hart is scrambling for help through Halifax Health's patient assistance to get money for the chemotherapy treatment she needs.

Help could be on the way for people like Hart. Gov. Rick Scott lent his support this week to expanding Medicaid to cover 900,000 more Floridians. Initially, he resisted this aspect of the health care law, saying it would be far too costly in the long term.

If approved by the Legislature, the move will have a big effect locally, extending coverage to uninsured residents, pumping revenue into local hospitals and perhaps even lowering local tax rates that help cover the costs of indigent care.

Florida has some of the most stringent Medicaid enrollment requirements in the country. A family of three must earn less than $11,000 to qualify.

The federal health care law gives the state the option of expanding the eligibility to 138 percent of the poverty line — about $15,000 for an individual or $32,000 for a family of four. The federal government has pledged to pay 100 percent of the cost for three years and at least 90 percent thereafter.

That would help extend coverage to some of the 105,000 uninsured people living in Volusia and Flagler counties.

The Medicaid expansion is good news for hospitals, especially considering they are giving up federal funding sources for uninsured patients under the health care law, said Daryl Tol, a Florida Hospital regional CEO for Volusia and Flagler counties.

"Expanding Medicaid is a coverage component that can bring some positives, " he said. "I see that as great news for us and our community."

Hospital officials are watching to see if some employers stop offering health insurance for their employees, a possible unintended consequence of health care reform, Tol said. Medicaid reimburses at a much lower rate than commercial insurance plans.

Halifax Health also views the expansion favorably, said hospital spokeswoman Ann Martorano. Halifax Health is providing $42.2 million in total uncompensated care. Insuring some of those patients will help lower that number, Martorano said.

The expansion could also affect Volusia County's three hospital taxing districts, which collect property taxes that help to pay for indigent care.

The West Volusia Hospital Authority, which collects $15.8 million in taxes to help meet the area's health care needs, will be analyzing how the expansion will affect its budget.

It's still too early to say what the effect will be, said Kathie Shepard, chairman of the West Volusia Hospital Authority.

More insured patients will help take some of the pressure off Halifax Health's patient assistance program, said John Johnson, chairman of the Halifax Health Board of Commissioners.

Not everyone is taking the expansion in stride, though. The governor's announcement cost him some support from the tea party, which views the health care law as paving the way toward a government-run health care system.

"A lot of the people in Florida who helped get him voted in and were enthusiastic on his stance against Obamacare are a little disappointed," said Ray Sanchez, a tea party member and president of the Volusia 9-12 Project. "I believe he is caving into what the federal government is doing. Unfortunately, it will affect our state in a negative way, and it will ultimately bankrupt the state."

For Hart, regardless of what happens in Tallahassee, she'll continue fighting cancer.

<p>HOLLY HILL &mdash; Fifty-eight-year-old Brenda Hart is one of hundreds of thousands of Floridians who slip through the cracks of the health care system. </p><p>The Holly Hill resident worked most of her life but lost her insurance when she came down with colon cancer. She tried to apply for Medicaid only to receive a letter stating she earns too much income to qualify. </p><p>Hart and her husband have a combined household income of $15,000, said their daughter Heather Sanders, 36. </p><p>"I never realized until my mom got sick how bad the system really is," Sanders said. "Everybody talks about this hole. I never thought they would be in this hole at $15,000." </p><p>Now, Hart is scrambling for help through Halifax Health's patient assistance to get money for the chemotherapy treatment she needs. </p><p>Help could be on the way for people like Hart. Gov. Rick Scott lent his support this week to expanding Medicaid to cover 900,000 more Floridians. Initially, he resisted this aspect of the health care law, saying it would be far too costly in the long term. </p><p>If approved by the Legislature, the move will have a big effect locally, extending coverage to uninsured residents, pumping revenue into local hospitals and perhaps even lowering local tax rates that help cover the costs of indigent care. </p><p>Florida has some of the most stringent Medicaid enrollment requirements in the country. A family of three must earn less than $11,000 to qualify. </p><p>The federal health care law gives the state the option of expanding the eligibility to 138 percent of the poverty line &mdash; about $15,000 for an individual or $32,000 for a family of four. The federal government has pledged to pay 100 percent of the cost for three years and at least 90 percent thereafter. </p><p>That would help extend coverage to some of the 105,000 uninsured people living in Volusia and Flagler counties. </p><p>The Medicaid expansion is good news for hospitals, especially considering they are giving up federal funding sources for uninsured patients under the health care law, said Daryl Tol, a Florida Hospital regional CEO for Volusia and Flagler counties. </p><p>"Expanding Medicaid is a coverage component that can bring some positives, " he said. "I see that as great news for us and our community." </p><p>Hospital officials are watching to see if some employers stop offering health insurance for their employees, a possible unintended consequence of health care reform, Tol said. Medicaid reimburses at a much lower rate than commercial insurance plans. </p><p>Halifax Health also views the expansion favorably, said hospital spokeswoman Ann Martorano. Halifax Health is providing $42.2 million in total uncompensated care. Insuring some of those patients will help lower that number, Martorano said. </p><p>The expansion could also affect Volusia County's three hospital taxing districts, which collect property taxes that help to pay for indigent care. </p><p>The West Volusia Hospital Authority, which collects $15.8 million in taxes to help meet the area's health care needs, will be analyzing how the expansion will affect its budget. </p><p>It's still too early to say what the effect will be, said Kathie Shepard, chairman of the West Volusia Hospital Authority. </p><p>More insured patients will help take some of the pressure off Halifax Health's patient assistance program, said John Johnson, chairman of the Halifax Health Board of Commissioners. </p><p>Not everyone is taking the expansion in stride, though. The governor's announcement cost him some support from the tea party, which views the health care law as paving the way toward a government-run health care system. </p><p>"A lot of the people in Florida who helped get him voted in and were enthusiastic on his stance against Obamacare are a little disappointed," said Ray Sanchez, a tea party member and president of the Volusia 9-12 Project. "I believe he is caving into what the federal government is doing. Unfortunately, it will affect our state in a negative way, and it will ultimately bankrupt the state." </p><p>For Hart, regardless of what happens in Tallahassee, she'll continue fighting cancer. </p><p>"You have to keep your spirits up," Hart said.</p>